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The objective was to determine whether therapeutic failure in patients infected with <jats:italic>Staphylococcus<\/jats:italic> spp. is linked to biofilm production, the presence of the <jats:italic>ica<\/jats:italic> operon, and the bacterial insertion sequence element <jats:italic>IS<\/jats:italic>256.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>\n              <jats:italic>Staphylococcus<\/jats:italic> spp. isolates from patients with device-related infections were collected. Therapeutic failure with proper antimicrobial treatment was registered. Biofilm phenotype was determined by Congo red test agar and Christensen assay. Presence of the <jats:italic>ica<\/jats:italic> operon genes <jats:italic>A-D<\/jats:italic> and <jats:italic>IS<\/jats:italic>256 was detected by PCR. Differences were compared through <jats:italic>x<\/jats:italic>\n              <jats:sup>2<\/jats:sup>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>100 isolates from staphylococcal infections episodes were included: 40 sepsis\/bacteremia, 32 ependymitis, and 28 peritonitis. 73.77% of CoNS and 79.5% of <jats:italic>S. aureus<\/jats:italic> isolates harbored the <jats:italic>icaD<\/jats:italic> gene, 29% of all isolates <jats:italic>IS<\/jats:italic>256-A+ <jats:italic>IS<\/jats:italic>256-D genes, <jats:italic>icaA<\/jats:italic> and <jats:italic>icaB<\/jats:italic> genes were only found in CoNS (27.8% and 21.3% respectively). Therapeutic failure occurred in 95.4.% of patients with a positive <jats:italic>IS<\/jats:italic>256-A+ <jats:italic>IS<\/jats:italic>256-D <jats:italic>S. epidermidis<\/jats:italic> isolate, RR 5.49 (CI 95% 2.24-13.44 p \u2264 0.0001), and 85.76% in CoNS isolates, RR 2.57 (CI 95% 0.97-6.80, p = 0.05). Although none <jats:italic>S. aureus<\/jats:italic> was positive for <jats:italic>IS<\/jats:italic>256-A + <jats:italic>IS<\/jats:italic>256-D, therapeutic failure was observed in 35.8%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The presence of <jats:italic>icaA\/D<\/jats:italic> genes along with the sequence element <jats:italic>IS<\/jats:italic>256 was associated with therapeutic failure in most CoNS infections, even though its absence in <jats:italic>S. aureus<\/jats:italic> isolates does not ensure therapeutic success.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-10-68","type":"journal-article","created":{"date-parts":[[2010,3,16]],"date-time":"2010-03-16T07:16:07Z","timestamp":1268723767000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Production of icaADBC-encoded polysaccharide intercellular adhesin and therapeutic failure in pediatric patients with staphylococcal device-related infections"],"prefix":"10.1186","volume":"10","author":[{"given":"Bernardo","family":"Diemond-Hern\u00e1ndez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortino","family":"Sol\u00f3rzano-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Lea\u00f1os-Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leoncio","family":"Peregrino-Bejarano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Miranda-Novales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2010,3,15]]},"reference":[{"key":"1048_CR1","doi-asserted-by":"publisher","first-page":"3799","DOI":"10.1128\/IAI.68.7.3799-3807.2000","volume":"68","author":"M Dietrich","year":"2000","unstructured":"Dietrich M, Holger R, Dobinsky S, Riedewald J, Nedelmann M, Knobloch JM: Identification of three essential regulatory gene loci governing expression of Staphylococcus epidermidis polysaccharide intercellular adhesin and biofilm formation. 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